A seat in the lifeboat

Photo from The National Archives

I spent a good chunk of today at an outpatient breast clinic in Nashville, getting a follow-up to a suspicious mammogram. Dave came along and was admirably cheerful about getting stuck in a waiting room for hours. The news, when it finally came, was good. I'm feeling lucky, happy, and relieved. I'm also feeling very rich.

The breast center is part of a huge medical complex that serves this entire region. People routinely drive from as far away as Alabama and Kentucky to get care there. But the women crowding the waiting room today didn't look anything like a cross-section of the people hereabouts. There were very few black faces, no Latinas at all, and the affluent end of the prosperity spectrum was definitely overrepresented.

Over our celebratory lunch, Dave and I wondered aloud about the missing women, especially all the ones who aren't poor enough for Medicaid and have no health insurance. How many of them ever get a mammogram? I tend to view conventional medicine with a wary eye, but there's no question that catching cancer when it's a miniscule dot rather than a palpable lump increases your odds of surviving it. Because of a past health problem, we have to pay an exorbitant amount for my health insurance, but an experience like this mammogram scare makes me extremely grateful that we can pay it. I feel as if we've managed to buy me a seat in the lifeboat. (You can find U.S. Census data on all the people who don't get a seat here.)

I was curious when I got home, and started hunting around the web to see where one goes to get a cut-rate mammogram in Nashville. There are a number of places, as it turns out. The billing for my initial mammo was $580, and you can see from the list that there are several clinics in town that will do a self-referred one for $50, which appears to include the reading. Still, $50 is a lot of money if you are just scraping by--plus, you need a physician to receive the results, which will cost something. Of course, all this begs the question of what you're going to do about paying for treatment if it turns out you need it.

It's all just a reminder of how "women's issues" are inseparable from larger issues of social justice. Periodically there's a flurry of press about how women are underserved by the medical establishment, either because too much research ignores them, or because sexism creates barriers to adequate treatment; but even a system that served women perfectly would still be useless to all the women who are locked out of it from the start.

*A little aside here on the larger issue of women's health: The New York Times has an article today about abortion rates around the world, which includes the unsurprising fact that women in poor countries are more likely to have abortions, and more likely to die from them. Lack of access to both contraception and safe pregnancy termination means more death, no matter how you look at it. All the "pro-lifers" who oppose foreign aid for anything but teaching abstinence ought to think about that.